Paper, paper everywhere, still swimming in the ink

Written by Kate McDonald on 18 August 2017.

It was no surprise that the most popular story this week on Pulse+IT was our report on a workshop on secure messaging held at the HIC conference in Brisbane, where it was revealed that the National Authentication Service for Health (NASH) needed a major overhaul if it was ever going to be of any use to anyone.

Developing a useable authentication system has been a bottomless pit from which little has emerged in the decade or so that we've been covering it. As we wrote back in 2010, NASH has been an integral part of the eHealth agenda since NEHTA's inception in 2005, but where once outsourcing sounded good it quickly turned terminal, and even though the Department of Human Services came to the rescue in the PCEHR days, NASH has caused trouble ever since.

At the workshop, a well-known series of photos was shown of an employee at Mukesh Haikerwal's practice in Melbourne almost drowning in piles of paper waiting to be scanned, which raised the usual titter of exasperation from the audience. So it was fascinating to read a story from the US this week about a group practice that has dumped its EMR and returned to paper, so exasperated were its clinicians with the electronic system they used.

"We have over 70 employees, so we took a vote to see whether anyone thought the EHR was providing a better patient care experience or a better office experience," the practice's medical director says. "Not one person in the practice thought we should keep the EHR."

Much as we hear of the annoyance clinicians have for EMRs – which is not true of primary care PMSs, which are reasonably well respected in Australia and New Zealand – we have yet to hear of anyone who wants to go back to paper, but let us know by taking our poll if you do.

Our top stories this week have pretty much all been about the same things we were covering a decade ago: the move from paper to scanned to electronic. There has been some progress in the hospital sector, as the Checkley Group's Bruce Pedersen says in another of our most popular stories, but the age-old problem remains: how do we harness the power of EMRs but remove the albatross from around clinicians' necks and give them back what EMRs have taken away, namely face-to-face contact with their patients?

That brings together our poll questions from last week and this one. Last week, we asked if you thought the press was unfairly tough on EMR vendors. Sorry vendors, but our readers reckon you deserve it by a margin of 58 per cent to 42.

This week, we want to know if you'd consider reverting to paper, at least until something better came along. Sign up for our weekend edition to vote or leave your comments below.

Comments

We are a rural GP clinic with 10 doctors (6 FTE). No way would we revert to paper records. Electronic health records have so many benefits - searchable, less storage space, less risk of paperwork going missing. We still seem to have a lot of paper in the office - mainly through letters from specialists - but we scan those and work off the electronic records where possible.

I am psychiatrist in private practice. I have subscribed to all of the major messaging systems (healthlink, MO, referralnet and Argus), and send everything I possibly can by secure messaging (i.e. I love it), I find that 99.% of GP's who refer to me are registered with one system or another. However, I have not once, EVER received anything from anyone - it is always fax or post. This is despite including all of my messaging addresses on all correspondence, and urging referrers to use secure messaging. After many months I was feeling lonely and concerned that maybe the system wasn't working and got the vendors to send me test messages - all arrived.I really think if we really want to stop using paper, faxes and scanners we all have to start using the available systems.